Arterial oxygen desaturation during awake endotracheal intubation.

Five patients requiring general anesthesia but presenting with compromised airways were successfully intubated by blind awake intubation with the aid of regional anesthesia and the use of appropriate sedation. Arterial blood gases were collected at three intervals: presedation, postsedation, and postintubation. Analysis of the blood gases revealed varying degrees of hypoxemia, hypercarbia, and acidosis following deep sedation before intubation. A decrease in oxygen saturation was also observed. Supplemental oxygen is suggested to avoid the effects of arterial desaturation during the sedation process. If oxygen is not administered, the risk of moderate hypoxia associated with blind awake intubation must be considered along with alternative problems including loss of protective reflexes or the inability to ventilate during induction and intubation via a direct technique.

Analysis of preoperative laboratory values prior to outpatient dental anesthesia.

A retrospective study of 672 ASA Class I patients undergoing outpatient general anesthesia for oral surgical procedures was performed to evaluate the significance and incidence of abnormal preoperative serum glucose and hematocrit levels. There was an 11% overall incidence of "abnormal" values. Specifically, 6% of the patients had serum glucose levels below 60 g/dl and 5% had hematocritis less than 35 mg/dl. These values are not outside the realm of normal and had no impact on the preoperative, perioperative, or postoperative anesthetic management. The results of this study and review of the suggest that routine laboratory analysis is of little value in the anesthetic management of ASA Class I patients in which a thorough history and physical examination is obtained.